Red flags & when to go in person for Patellofemoral Pain Syndrome

Audience: pediatric

Patellofemoral Pain Syndrome (PFPS) is a common cause of knee pain in children and teens, often related to activity or overuse. It typically causes pain around or behind the kneecap and may worsen with running, climbing stairs, or sitting for long periods. Most cases improve with rest, gentle exercises, and avoiding activities that cause pain. Telemedicine can help assess symptoms, provide advice on pain relief, and guide safe activity levels. However, some signs mean an in-person visit is needed, such as severe pain, swelling, inability to walk, or signs of infection. Early recognition of these red flags helps ensure proper care and prevents complications. This guide explains when to seek in-person care and what telemedicine can and cannot do for PFPS in young people.

Red flags — go in person / ER

• Severe knee pain that limits walking or daily activities — seek in-person evaluation promptly.
• Swelling, redness, or warmth around the knee, especially with fever — possible infection requiring urgent care.
• Sudden knee deformity, inability to bend or straighten the knee, or a popping sound at injury — immediate medical attention needed.

What telemedicine can do

• Initial symptom assessment and history taking.
• Providing advice on pain management and activity modification.
• Guiding home exercises for knee strengthening and flexibility.
• Monitoring symptom progress and deciding on need for in-person care.

What telemedicine cannot do

• Physical examination to assess knee joint stability and alignment.
• Ordering and interpreting imaging tests (X-rays, MRI).
• Treating severe injuries, infections, or complications requiring urgent care.
• Performing procedures or manual therapies.

What is Patellofemoral Pain Syndrome?

Patellofemoral Pain Syndrome (PFPS) is knee pain that comes from the area around the kneecap (patella). It is common in active children and teenagers. The pain often happens after activities like running, jumping, or climbing stairs. It may feel like a dull ache or soreness, especially when sitting with bent knees for a long time.

Common Symptoms of PFPS

Symptoms usually include:

These symptoms often improve with rest and simple exercises.

When to Seek In-Person Care

Some symptoms need prompt medical attention in person:

If you notice these signs, please see a healthcare provider in person.

How Telemedicine Can Help

Telemedicine can be useful for:

It allows easy access to care without travel, especially for mild-to-moderate symptoms.

Limitations of Telemedicine for PFPS

Telemedicine cannot:

If symptoms worsen or red flags appear, an in-person visit is necessary.

How to prepare for your tele-visit

• Have a list of symptoms ready, including when they started and what makes them better or worse.
• Prepare to describe any recent injuries or activities that may have caused knee pain.
• Find a quiet, well-lit space for the telemedicine visit.
• Have a family member or caregiver available to assist if needed.
• Prepare questions about pain relief, activity limits, and exercises.

After your tele-visit

• Follow the recommended pain management and activity advice.
• Perform suggested exercises regularly as instructed.
• Watch for any new or worsening symptoms, especially red flags.
• Schedule follow-up telemedicine or in-person visits as advised.
• Seek immediate care if red flags or severe symptoms develop.

FAQs

What causes Patellofemoral Pain Syndrome in children?

PFPS often results from overuse, muscle weakness, or poor alignment of the kneecap during movement. Activities like running, jumping, or sports can strain the knee joint and cause pain.

Can PFPS heal on its own?

Many cases improve with rest, avoiding painful activities, and doing exercises to strengthen the muscles around the knee. Healing can take weeks to months depending on activity levels and care.

Is it safe to keep exercising with knee pain?

It's important to avoid activities that cause pain. Gentle, guided exercises to strengthen the knee can help recovery. Always follow healthcare advice to avoid worsening symptoms.

When should my child see a doctor in person?

If your child has severe pain, swelling, redness, fever, cannot walk, or has a knee deformity, seek in-person medical care promptly. These signs may indicate a more serious problem.

Can telemedicine replace all knee care?

Telemedicine is helpful for initial advice and monitoring mild symptoms, but it cannot replace physical exams or imaging needed for serious conditions. In-person visits may be necessary.

Sources

1. Patellofemoral Pain Syndrome — MedlinePlus, U.S. National Library of Medicine.
2. Patellofemoral Pain Syndrome: Clinical Review — National Library of Medicine.
3. Knee Pain in Children and Adolescents — American Academy of Pediatrics.
4. Patellofemoral Pain Syndrome (Runner's Knee) — Mayo Clinic.

This telemedicine guidance is for education and triage only. It is not a substitute for in-person medical evaluation, diagnosis, or treatment. If you have concerns or red flag symptoms, please seek care from a healthcare provider in person.